Terminalia arjuna

Arjuna (also known as the Arjuna tree and under the botanical name Terminalia Arjuna) is a medicinal plant that is mainly used to treat heart problems due to its heart-protective and heart-strengthening properties. Arjuna strengthens the heart muscle and normalizes the heartbeat. In addition to this, Arjuna is a good source of minerals that could help prevent bone loss (osteoporosis) and improve bone density. Arjuna also has protective effects against ulcers, especially stomach ulcers. It stops bleeding, which is why it can be helpful in bleeding disorders. It reduces the frequency of urination, which is why it can be helpful for polyuria and frequent urge to urinate. It has an astringent effect, which is why it can be helpful in controlling leucorrhea.

Medically effective ingredients of Arjuna

The bark of the Terminalia arjuna tree is the primary part used for therapeutic purposes. The bark is known for its cardioprotective effects.

Chemical composition

Terminalia Arjuna bark contains minerals such as calcium and magnesium. The following phytochemicals are found in Arjuna bark:

1. Phenolic compounds: Terminic acid and arjunolic acid
2. Glycosides: arjunetin and the arjunosides I-IV
3. flavones
4. tannins
5. Oligomeric proanthocyanidins
6. B-sitosterol
7. Casuarinin
8. Phenolic acids: ellagic acid and gallic acid
9. Lactones

Pharmacological effects

Terminalia Arjuna bark has a cardioprotective effect, which is based on the fact that it replenishes depleted stores of myocardial antioxidants and improves heart function (1). According to Ayurvedic medicine, Arjuna bark strengthens the heart, improves blood flow to the heart tissue and increases the pumping power of the heart. These effects have been verified by medical studies.

Potential health benefits and medical applications

In Ayurvedic medicine, Arjuna bark is primarily used to treat heart diseases and as a heart tonic. In addition to this, it is also used for other diseases. Arjuna is also being studied for the treatment of ulcers, diabetes and cancer.

Terminalia Arjuna is rich in antioxidants

Antioxidants are substances that neutralize highly unstable molecules called free radicals. Free radicals have been linked to chronic diseases such as heart disease, type 2 diabetes and cancer. Many compounds contained in Terminalia Arjuna such as flavonoids, triterinene, glycosides and phenolic acids act as antioxidants (18).

In vitro studies have shown that antioxidants contained in Terminalia Arjuna suppress the growth and spread of stomach cancer, liver cancer and other cancers (19). Terminalia Arjuna can promote and improve the health of the cardiovascular system Terminalia Arjuna improves the function of the left ventricle. It strengthens the heart muscle and improves the heart's capacity to pump blood. It has cardioprotective effects that help maintain optimal heart function and speed recovery from injury to the heart muscle. Arjuna is most commonly used to prevent heart attacks as it has anti-arterogenic properties that help reduce plaque buildup in the coronary arteries and improve blood flow to the heart tissue. Terminalia Arjuna is helpful for people suffering from myocardial ischemia where blood flow to the heart is reduced. It improves blood flow to the heart and reduces blockages in the coronary arteries. In addition to this, Arjuna as a cardiac tonic improves the tone and strength of the heart muscle and improves the ability of the heart to pump blood efficiently. This increases the ejection capacity of the left ventricle in people suffering from heart disease. Arjuna also has antioxidant properties that help maintain heart health. In Ayurvedic medicine, Arjuna is recommended for the prevention of heart disease in people suffering from diabetes and hypertension.

Terminalia arjuna can counteract arteriosclerosis

Terminalia arjuna has anti-arterogenic and hypolipidemic properties. It also reduces subliminal inflammation of the blood vessels and its antihyperlipidemic effects lower serum concentrations of total cholesterol, LDL cholesterol, VLDL cholesterol and triglycerides. It also reduces the arterogenic index. A study conducted with rabbits suggests a reduction of arteriosclerotic lesions in the aorta by Arjuna. These effects are most likely due to its antihyperlipidemic, anti-inflammatory and antioxidant properties (2, 3). For these reasons, Arjuna can be used to reduce atherosclerotic lesions and prevent the progression of atherosclerosis due to its anti-arterogenic effects.

Terminalia Arjuna can counteract heart failure

Terminalia Arjuna reduces manifestations of heart failure. It increases the stroke volume and the ejection capacity of the left ventricle. Studies also suggest that it may enhance exercise performance and increase exercise tolerance (4).' Terminalia Arjuna bark improves cardiac performance and the contractility index of the heart muscle. It prevents and reduces cardiac dysfunction and aids in recovery after injury to the heart muscle in heart failure, as suggested by a study conducted on rats. This study also suggests that Arjuna bark inhibits lipid peroxidation and acts as an antioxidant. Its effects were comparable to fluvastatin, a drug used to lower cholesterol levels (5, 6). Arjuna is used in combination with ashwagandha to strengthen the heart. In Ayurvedic medicine, Arjuna bark is used as Arjuna Ksheera Pak or Ashwagandha Arjuna Ksheera Pak for the treatment of heart failure. Arjuna helps reduce edema and is generally recommended along with Punarnava (Boerhavia Diffusa) formulas like Punarnavarishta, Punarnavasava, Punarnavadi Kashayam of Punarnava Mandur for best results.

Terminalia Arjuna can alleviate diseases of the coronary arteries

Coronary artery disease is a common cause of heart failure and uncontrolled high blood pressure. Terminalia Arjuna helps prevent progression of these conditions and further plaque buildup by reducing underlying inflammation of the blood vessels and coronary arteries. It also keeps cholesterol deposits and plaque formation under control. It can reduce serum cholesterol levels, triglyceride levels, LDL cholesterol levels and the artherogenic index (7, 8). Since Arjuna alone may not be sufficient to treat coronary artery disease, it is often used in combination with the following Ayurvedic formulas in the field of Ajurvedic medicine:

• Pushkarmool (Inula Racemosa)
• Shuddha Guggulu (Purified Guggul)
• Triphala (three myrobalans)
• Kutki (Picrorhiza Kurroa)
• Tamra Bhasma (Copper)
• Trikatu Churna

Terminalia Arjuna could be used to prevent heart attacks

In rats, treatment with Terminalia arjuna in combination with alpha-trocopherol protected against injury to the heart muscle caused by isoproterenol. The study suggested the prophylactic value of Terminalia Arjuna in the treatment of myocardial infarction (heart attacks) and myocardial ischemia, as it increases the amount of endogenous antioxidants in the heart tissue, which protects the heart from trauma and injury (9).

Terminalia Arjuna could alleviate ischemic mitral regurgitation

One study suggests that Terminalia Arjuna may reduce ischemic mitral regurgitation and reduce the frequency of angina pain. It also improves the E/A ratio after 3 months of use, which is an indicator of improved left ventricular function (10).

Terminalia Arjuna can relieve shortness of breath

In cardiac patients, narrowing of the coronary arteries reduces the oxygen supply to the heart, which can result in shortness of breath. As described above, Terminalia Arjuna reduces constriction of the blood vessels by treating underlying inflammation and reducing plaque buildup in the blood vessels, which can help alleviate breathing problems in heart patients. For best results, it should be used in combination with the other medicinal herbs described above for coronary artery disease.

Terminalia Arjuna can help with angina pectoris

Terminalia Arjuna bark has antianginal and cardioprotective properties. One study suggests that it may be effective in cases of stable angina pectoris. However, its effects in unstable angina pectoris are limited and it does not reduce anginal frequency in such cases. Arjuna can lower systolic blood pressure and significantly increase levels of good HDL cholesterol. No side effects with regard to kidney and liver function have been observed (11, 12, 13).

Terminalia Arjuna can help with tachycardia and palpitations

Terminalia Arjuna bark powder is successfully used in Ayurvedic medicine to treat tachycardia and palpitations. A three-month therapy can significantly reduce palpitations and an abnormally high heart rate.

Terminalia Arjuna can reduce high blood pressure

Even though Terminalia Arjuna bark can initially constrict blood vessels due to its constricting effect, it subsequently influences the heartbeat and lowers blood pressure. According to studies, this effect can be observed more in systolic blood pressure (14, 15). In addition, Arjuna prevents vasoconstriction by reducing atherosclerotic lesions and plaque buildup in blood vessels, while lowering cholesterol levels and elevated blood lipid levels. For these reasons, long-term use can have a positive effect on the control of high blood pressure due to arteriosclerosis or vasoconstriction. The same applies to high blood pressure associated with high cholesterol levels or dyslipidemia.

Terminalia Arjuna may have benefits for lipid metabolism disorders and elevated cholesterol levels

Terminalia Arjuna bark has blood lipid-lowering and antioxidant properties that may help reduce cholesterol levels, triglyceride levels, LDL cholesterol levels, VLDL lipoprotein levels and the arterogenic index. These effects may be due to the actions of phytochemicals such as tannins, saponins and flavonoids present in Ajurna bark (16, 17).

Terminalia Arjuna can alleviate bleeding and bleeding disorders

The astringent compounds in Arjuna bark can reduce bleeding. This may be due to the fact that Arjuna can cause blood vessels to constrict, which can help reduce bleeding. Arjuna is used in Ayurvedic medicine in combination with other medicinal herbs for bleeding disorders.

Terminalia Arjuna could accelerate the healing of bone fractures

In Ayurvedic medicine for bone fractures, a paste of Arjuna bark mixed with water is applied to the fracture area twice a day until the healing process is complete. In addition to this, 3 to 4 grams of Arjuna root powder in combination with 2 grams of Cissus Quadrangularis is taken twice a day. This is believed to accelerate the proliferation of physiological processes, thereby promoting the healing of fractures. Terminalia Arjuna can be helpful in the treatment of chronic low fever In the field of Ayurvedic medicine, Arjuna bark is used to treat chronic low fever, which is associated with extreme fatigue and physical weakness. Although Arjuna is not the perfect antipyretic medicine, it appears to support other medicines used to fight infection and fever. In addition to this, Arjuna appears to counteract exhaustion and weakness and restore physical strength.

Terminalia Arjuna could be helpful in the treatment of dysentery

In Ayurvedic medicine, Arjuna is used together with other Ayurvedic preparations to treat dysentery. This combination seems to reduce blood in the stool and the frequency of bowel movements and cure the infection.

Terminalia Arjuna could promote wound healing

In Ayurvedic medicine, preparations of Terminalia arjuna bark are used to wash out wounds and ulcers. Due to its antibacterial effects, arjuna appears to kill microbes - especially certain strains of bacteria - and promote wound healing.

Terminalia Arjuna could alleviate or prevent stomach ulcers

In the field of Ayurvedic medicine, Arjuna bark powder and its aqueous extracts are successfully used to treat and protect against gastric ulcers and its protective effect is said to be comparable to that of the gastric acid blocker Rantindin.

Terminalia Arjuna could help control blood sugar levels

Studies carried out on animals suggest that Terminalia Arjuna could lower blood sugar levels. In a study conducted with mice, scientists discovered that Terminalia Arjuna significantly lowered fasting blood glucose levels more than a placebo (20). A study conducted on rats with diabetes found that treatment with a Terminalia arjuna extract for 15 days significantly lowered and normalized fasting blood glucose levels (21). Other studies conducted with mice have also found that the ingredients of a Terminalia Arjuna preparation could significantly lower fasting blood glucose levels (22, 23).

Terminalia Arjuna could improve exercise performance

A study conducted with 30 young adults found that Terminalia Arjuna can increase aerobic exercise performance (24).

The safety profile of Arjuna

Terminalia Arjuna is used in various forms including bark juice, bark powder, decoction, etc. All dosage forms of Arjuna are considered safe and well tolerated by most people when used in the recommended dosages. According to a study conducted on rats, 2 grams of an ethanol extract of Arjuna per kilogram of body weight showed no toxic effects (25). According to clinical studies, Terminalia Arjuna is probably safe and harmless at the recommended doses. Arjuna does not cause adverse effects on kidney and liver function (26). Long-term use of Arjuna bark powder also has no side effects and is probably safe for the liver and kidneys. No significant changes in blood values have been observed (27, 28). Arjuna bark extracts are probably safer than Arjuna leaf extracts and should be preferred over them.

Precautions and warnings

• Pregnancy: There is evidence that Terminalia Arjuna may not be safe and harmless during pregnancy. For this reason, Arjuna should not be used during pregnancy as a precaution.
• Lactation: There is not enough reliable information to know whether Arjuna is safe to use during lactation. For this reason, Arjuna should not be used by breastfeeding women for safety reasons.
• Blood clotting disorders: Terminalia can slow down blood clotting. This could increase the risk of bruising and bleeding in people with blood clotting disorders.
• Diabetes: Terminalia Arjuna may lower blood sugar levels. Diabetes medication may need to be adjusted for diabetics.
• Surgery: Terminalia Arjuna may affect blood sugar control during surgery and increase the risk of bleeding. For this reason, the use of Arjuna products should be discontinued at least 2 weeks prior to upcoming surgery.

Dosages used

The following dosages were used in scientific studies: For chest pain: 500 mg of Terminalia Arjuna bark powder three times daily was used in combination with conventional therapy for chest pain for up to 3 months.

References

1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728868/
2. http://www.ncbi.nlm.nih.gov/pubmed/21785628
3. http://www.ncbi.nlm.nih.gov/pubmed/26934842
4. http://www.ncbi.nlm.nih.gov/pubmed/7649665
5. http://www.ncbi.nlm.nih.gov/pubmed/21116736
6. http://www.ncbi.nlm.nih.gov/pubmed/21828283
7. https://www.ncbi.nlm.nih.gov/pubmed/11225136
8. https://www.ncbi.nlm.nih.gov/pubmed/25907198
9. http://www.ncbi.nlm.nih.gov/pubmed/25180938
10. http://www.ncbi.nlm.nih.gov/pubmed/15837100
11. http://www.ncbi.nlm.nih.gov/pubmed/7741874
12. http://www.ncbi.nlm.nih.gov/pubmed/9505018
13. http://www.ncbi.nlm.nih.gov/pubmed/12086380
14. http://www.ncbi.nlm.nih.gov/pubmed/7741874
15. http://www.ncbi.nlm.nih.gov/pubmed/21170205
16. https://www.ncbi.nlm.nih.gov/pubmed/11225136
17. https://www.ncbi.nlm.nih.gov/pubmed/25907198
18. https://pubmed.ncbi.nlm.nih.gov/25379463/
19. https://pubmed.ncbi.nlm.nih.gov/30070707/
20. https://pubmed.ncbi.nlm.nih.gov/29249636/
21. https://pubmed.ncbi.nlm.nih.gov/21281245
22. https://pubmed.ncbi.nlm.nih.gov/26342523
23. https://pubmed.ncbi.nlm.nih.gov/22803325
24. https://pubmed.ncbi.nlm.nih.gov/21170205
25. http://www.ncbi.nlm.nih.gov/pubmed/21785628
26. http://www.ncbi.nlm.nih.gov/pubmed/7741874
27. http://www.ncbi.nlm.nih.gov/pubmed/9505018
28. http://www.ncbi.nlm.nih.gov/pubmed/9080336